"That is happiness; to be disolved into something complete and great. When it comes to one, it comes as naturally as sleep." - Willa Cather

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Tuesday, 6 March 2012

The reason my chest looks like b

Just because I'm a doctor does not mean I don't have those mornings where I wake up thinking "I wonder if I have a brain tumor..."

I said to SR before he left for his 24 shift,"My left foot, left calf, left shoulder and left eye all hurt. And now my left breast has stopped producing milk. Do you think they are related?"

"No" he said, quickly gathering his stuff.

So I let go of the brain tumor idea when I could not localize a tumor that would explain all of this. And then I thought, if I forget about the eye, perhaps my back being out of alignment could explain the rest.

Not an hour later a woman walked up to me and exclaimed my first name in the woman's locker room at the Y. Oh my gosh, Kelly, my old chiropractor from when I was pregnant with The Lorax. I hadn't seen her in ages!

I told her my story,:the shoulder, leg, foot and boob on the left. And she said "Oh, yeah, totally! It must be the nerve". Despite me having no idea what nerve she was talking about, I got so swept up in the idea that I also said "oh, yeah!" I called and made an appointment to see her tomorrow. But by the time El Guapo woke up from his nap, there was milk dripping from my left boob.

??????

I just have to add two interesting tidbits:

1. during the about 4 days where my left boob was not producing, the right one doubled in production. Just like that. Take a person who is already extremely self-conscious about how she looks and then add that and you have got a woman in very baggy clothing!

2. The left side is the side that El Guapo sleeps on so it is odd that the left was the side that gave out - but it has always produced less ("the slacker" a la Piccola Pinecone)

I looked up the connection between a nerve and breast milk production, ready to be amazed by yet another fact I didn't learn in med school, only to find no nerve involved in lactation. There was, however a case report from a chiropractor of his amazing restoration of lactation. (My chiropractor could also have written one had my milk come back tomorrow after the appointment, of course).

Cow's milk and babies

As long as we're discussing milk & babies, I had to bring this up. Have you ever been on a transatlantic flight with a 4 month old baby and run out of breast milk and thought about giving the baby the little milk that was included with the dinner? No? Well, then you are smarter than I am. I did this and then could not get rid of this nagging feeling that I had read an article about cow's milk being associated with the development of Type 1 diabetes. I let it go, though, since I figured it was more lack of breastfeeding that predisposed to Type 1 diabetes. Well, that may not be the case, there is some mixed evidence, but one study from Finland (where the incidence of type 1 diabetes is the highest in the world - likely due to lack of vitamin D and NOT sauna sitting during pregnancy!) showed that any exposure of babies less than 2 months to cow's milk increased their risk of type 1 diabetes. And a study in JAMA showed introducing babies to gluten before 6 months also increases their risk of type 1 diabetes. These studies were done in populations with familial type 1 diabetes to show something significant. And there have been studies that have suggested cow's milk is actually ok (as long as it doesn't substitute breast milk), but the verdict is still out. I just thought young mothers should know it's probably best to avoid gluten and milk products until the baby is 6 months.

Oh- and why don't Americans supplement babies with Vitamin D drops?? Or do they (they should, especially dark skinnned babies or babies breast fed by dark skinned moms!)? Not just to help prevent diabetes, but also rickets and hypocalcemia.

Sorry this is a rambling, unorganized post, but time is limited around here!

14 comments:

Ha ha, I call one of my boobs the "loser boob" (coincidentally also the left one). About five days after Johanna was born, it was making so little compared to the other one that I had a few hours of total panic while googling all search phrases related to my problem. My midwife assured me it was incredibly common and not to worry. Happy for you that your left side has decided to pick up some of the slack.

Thanks for the feeding tip for babies. The books on feeding I have read and the medical advice I've received here all recommend avoiding any foods other than breast milk or formula until six months. One book I read advised avoiding gluten until one year, and I laughed...I don't think Dutch people could avoid giving their children bread.

Do you think the Vitamin D drops aren't recommended in the U.S. because so many foods are fortified with Vitamin D?

I too had a left boob that was the slacker! Our pediatrician actually did recommend Vitamin D drops for the first year for all breastfed babies. We did it for awhile, but it was only another thing to remember to buy and put in her bottle during the day!

Glad your left breast came back to life (kinda). Hoping your other ailments recover, I know you love that loooong distance running.

We have really nothing in common, but I love how you push yourself beyond OTHER PEOPLE'S perceived limits that you 'should abide by'. You take risks, you think them through scientifically, and you execute. I don't always agree with your choices, but I love your chutzpa.

I think to myself "just because your right side went numb doesn't mean you can't run. Your neuro is a marathoner, as is your allergy/immunology Dr. and THEY said you can run." I'll probably run badly, I might fall. Hey, I might have an 'MS moment' and lose my way home (take cell phone). I'm still gonna try, though.

Vitamin D drops ARE recommended for breastfeeding babies in the US. I got the recommendation 3 times -- from my pediatrician, from the lactation consultant that came around at the hospital and also from the Neo-Natal nurse in the NICU (with my first baby who was a little premature). It was even on the form of instructions to remember that they gave me when we took our babies home. Bottom line -- I think it is a VERY standard recommendation in the U.S.

Funny you mention this vitamin D issue. I've read that a Vitamin D deficiency is suspected of causing MS. MS has been found to be geographical, even following certain latitude spreads. Evidently, Rochester NY is a hot bed for MS, we NEVER get any sun.

It's interesting you mention the Vit D supplements for breastfed infants. It was recommended to us for the first time with #4 (born a couple months ago). We picked up the drops, but aren't very consistent in giving them to her. I actually googled it to make sure it was a legitimate thing because I had never heard about vitamin supplementation for breastfed infants before.

Regarding the vitamin D supplementation, when I had my first baby 6 years ago it was not being recommended, but last year for my 2nd they recommended it and reminded me at every well visit since (for breastfed babies only, as I am pretty sure formula is fortified with vitamin D). I'm sure this is related to all the attention vitamin D has been getting lately.

as a practicing physician i find that you often quote studies without any scientific interpretation and just quote the results as the positive statistical value has clinincal relevance.also, all babies in NA are advised to get 400 IU of vitamin D, so here is another act you are unaware/outdated on.

Anon, for a commenter, you sure didn't read this post or my blog carefully! But that is par for the course around here from Anon commenters. Welcome to the large club!

First of all, I practice in Denmark and my question was whether or not it was recommended in the US. I don't practice in the US. I used to practice here when Vit D was not routinely recommended, but I recommended it nonetheless in babies, espeically those with more pigment.

Second of all, I do research for a living. I mention studies when I am interested in sharing something I have read or learned. All studies need to be very critically intepreted. Nearly all will one day be proven wrong in some way. But mentioning studies brings up very important points of disucssion.

Hello from Rude Skov

Photo by Stine Sophie Winckel

...

My name is Tracy. I am a physician scientist from the USA, living with my husband and two young boys in Denmark. I work as a post-doc fellow at Næstved Hospital. I have a scientific interest in vision loss, vision loss during exercise, exercise, running during pregnancy, MAF training as well as nutrition and health for athletes. I also have a love for music, physics, statistics, cycling, yoga, cross-country skiing, bla bla bal.

I was a member of Team USA at the IAU World Championships in Ultra Trail Running in 2013 in Wales. I am now training to run with Team Denmark at the IAU World Championships in Annency, France in May 2015.